allergy anaphylaxis

Question 1

3 most important peds allergies

Answer 1

1. food
2. drug
3. env

Question 2

patho of allergy

Answer 2

1. first time antigen binds to Th2 cell and stim ulates IgE production by B-cells
2. get large number of IgE that bind to mast cell and stay
3. sencond exposure binds to IgE on mast cell and cause cross-linking - degranulates the mast cell
4. mast cell releases histamine and cytokines

Question 3

effect of histamine and cytokines

Answer 3

histamine - immediate hypersens. - vascular smooth muscle response
cytokines - late phase inflammation

Question 4

Sx of immediate hypersens (4)

Answer 4

1. urticaria (hives)
2. wheeze
3. rhinitis
4. angioedema

Question 5

what is epi of food allergy in kids

Answer 5

1.5-5% - less common than people think

Question 6

what is allergic march

Answer 6

kids being developing allergies in sequence as they are exposed to them

Question 7

what is burden of env. allergies

Answer 7

very high - 6 billion

Question 8

Sx of env. allergy

Answer 8

1. rhinitis
2. salute
3. wheeze

Question 9

things to assess on Hx of allergy

Answer 9

• specific of CC
• Sx
• action taken and effect
• viral illness present?
• previous exposures
• previous treatments
• family Hx

Question 10

physical for allergy

Answer 10

often not symptomatic when seen

• swollen nasal mucosa
• rhinitis, hives, congestion
• signs and Sx of asthma

Question 11

what does skin prick test

Answer 11

presence of IgE, not necc allergy

Question 12

what should not be done with SPT

Answer 12

panel

Question 13

what is SPT good for and bad for

Answer 13

NPV is high

PPV is only 50%

Question 14

when is intracutanous test used

Answer 14

• penicillin, vaccines, venom

- only after -ve SPT

Question 15

what is gold standard test for food allergy

Answer 15

food challenge test

Question 16

what is radioallergenosorbent test

Answer 16

blood test looking for IgE

- SPT is more sensitive

Question 17

main treatment of allergy

Answer 17

avoidance of the foods

Question 18

pharma

Answer 18

• epi-pen

Question 19

other pharma

Answer 19

• anti-histamines
• nasal corticosteroids
• anti-leukotrienes

Question 20

when is immunotherapy good

Answer 20

for those that have failed all else

Question 21

general def. of anaphylaxis

Answer 21

compromised or severe involvement of resp andor/hypotension as well as features of skin and GI involvment

Question 22

triggers of anaphylaxis

Answer 22

• food
• insects
• meds
• exercise
• vaccines
• latex
• immunotherapy

Question 23

what is possible marker of anaphylaxis and use

Answer 23

serum tryptase

• needs to be taken at time
• only get back a week later

Question 24

2 course of anaphylaxis

Answer 24

uniphasic - normally

biphasic - can sometimes get second initiation

Question 25

**acute MGMT of ana

Answer 25

• ABCs

- 0.01cc/kg epi – IM!!